Bile Duct Diaries XI

Last Friday, we left our rather cosy treatment centre at home where our preoccupations are calorie intake, pain relief, bowel movements and choice of evening video, to return to the Royal Free to meet the oncologists. They are proposing 6 months of chemotherapy consisting of weekly, hospital-based infusions of the drug Gemcitabine (factsheet says it is pronounced: gem-sight-a-been). This is thought to be ‘well tolerated’, i.e. fewer side effects like sickness and loss of hair, but the usual tiredness, susceptibility to infection, and the possibility of food tasting different. Each person has a different reaction so we shall wait and see.

One reason pancreatic cancer has such a poor prognosis is that, to date, chemotherapy treatments are not very effective as they are with other cancers. Although strictly speaking, my tumour was in the bile duct within the pancreas rather than the pancreas proper, so that has a better prognosis. This is another reason why surgery is generally the treatment of choice, certainly at the Royal Free. But this chemotherapy should knock out free floating cancer cells as well others cells in the body that have not been detected because they are too small or they have not revealed themselves with symptoms. (Is this the oncologists equivalent of a MOT?).

I was taken aback when the doctor said he wanted to start in two weeks, because I don’t feel I have the body strength to deal with the chemicals. So there will be more blood tests and another meeting with a consultant next week, but their attitude is they don’t want to leave things.

This consultation felt like a significant step in accepting and consolidating some of what has been happening to me. Within the space of three months, I started as a ‘cancer person’, then a ‘pancreatitis person’, then became a ‘major operation person’, now I have become a ‘chemotherapy person’ and eventually I will be a ‘post-chemotherapy person’. (After that, I presume, I will once again have the same chances of avoiding being hit by a bus as everybody else!). It is hard to locate myself amongst all these major changes of identity, but I can feel this is happening as the treatment plan is settled and there aren’t so many ‘unknowns’ about the future occupying my thinking.

I have no idea about this next stage of treatment and recovery, so no idea yet about returning to work. Apparently some people can organise themselves to do some work while the chemo is going on, but at the moment it’s hard for me to imagine this because I still have some way to go to get over the operation. But I will keep you all informed.

I just have to say what a great team of carers has been assembled with Jane and Nancy and our kids. I couldn’t be in better hands. And Jane’s sister, Ann, from Los Angeles and her husband Peter are coming for a visit this weekend, so the family support, as well as London-based visits have been fantastic.

Bye for now, love to you all,
David (and Jane)

31 March, 2008